Organization
LANCASTER CONVALESCENT CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MYRIA POLYDOROU CPA (VF FINANCE)
(864) 582-8983
Entity
Organization
Contact information
Practice address
2044 PAGELAND HWY, LANCASTER, SC 29720-7608
(803) 285-7907
Mailing address
PO BOX 5419, SPARTANBURG, SC 29304-5419
(864) 582-8983
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
NCF551
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0551NH
—
SC
Enumeration date
10/10/2006
Last updated
08/22/2020
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